| NPI | 1295873248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULINE PARRISH Vice President & CFO 941-365-3913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME96883) |
| 3336C0002X Pharmacy, Clinic Pharmacy (Licence: FL FM3429342) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2018-01-19 |